{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T17:22:06Z","timestamp":1782321726083,"version":"3.54.5"},"reference-count":31,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Facial Plastic Surgery &amp; Aesthetic Medicine"],"published-print":{"date-parts":[[2024,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Although selective denervation (SD) improves clinician-graded, objective, and patient-reported smile symmetry, changes in resting symmetry have not been comprehensively studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To assess mid-term changes in resting facial symmetry after SD, and to evaluate changes in perceived emotions in faces at rest and with smiling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Nonflaccid facial paralysis (NFFP) patients undergoing SD were studied from September 2021 to October 2022. Patient-reported, clinician-graded, and objective metrics of resting and smile symmetry were quantified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Fourteen patients (median age 59.5 years; median paralysis duration 76.5 months; median follow-up 249.5 days (138\u2013400); average of 5.7 branches sacrificed) underwent SD. Resting oral commissure (OC) symmetry (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.028) and upper lip symmetry (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.030) improved after surgery. In smiling faces, OC excursion (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.004), smile angle (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.016), and dental show (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.012) improved. There were significant increases in perceived happiness at rest (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.006) and with smile (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.002). Clinician grading revealed improved nasolabial fold depth at rest (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.087) after surgery, and patients reported improved facial function and happiness with the decision to undergo surgery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Intermediate follow-up suggests SD can improve objective resting and smile symmetry in patients with NFFP. After surgery, patients' faces convey more happiness in repose and with smile.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/fpsam.2023.0149","type":"journal-article","created":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T10:21:31Z","timestamp":1699352491000},"page":"326-332","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Mid-Term Effects of Selective Denervation Surgery on Facial Symmetry in Patients with Nonflaccid Facial Paralysis: Intermediate Follow-Up of Rest and Smile Symmetry"],"prefix":"10.1177","volume":"26","author":[{"given":"Rahul","family":"Varman","sequence":"first","affiliation":[{"name":"Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology\/Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel P.","family":"O'Rourke","sequence":"additional","affiliation":[{"name":"University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan","family":"Nix","sequence":"additional","affiliation":[{"name":"Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology\/Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2470-3897","authenticated-orcid":false,"given":"Matthew Q.","family":"Miller","sequence":"additional","affiliation":[{"name":"Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology\/Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,6,6]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2018.0866"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2016.1462"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200103000-00005"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fsc.2015.04.005"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199612000-00009"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/fpsam.2020.0009"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000008807"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0000000000000727"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e3182a0df04"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000005590"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27986"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11102890"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.129.2.305"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1037\/emo0000525"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198901000-00001"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00450609"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.14.12857"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sjaa174"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2022.08.007"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1089\/fpsam.2020.0325"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1089\/fpsam.2020.0485"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1089\/fpsam.2020.0556"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000007674"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1098\/rstb.2019.0284"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0207695"},{"key":"e_1_3_5_27_2","doi-asserted-by":"crossref","unstructured":"Darwin C Prodger P. 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